Nyob ntiaj teb no muaj tshuaj kho tau sai heev. Kev ua tiav tau pom nyob hauv txhua qhov chaw. Qhov no siv rau kev phais thiab kev kho mob ntawm kev kho mob, kev kuaj mob, thiab kev tshawb pom kev tshawb fawb. Ophthalmology tsis muaj kev zam. Nrog rau qhov tshwm sim ntawm cov txheej txheem microsurgical, qhov kev phais qhov muag tau dhau los ua kev nyab xeeb thiab ua tau zoo dua. Qhov zoo ntawm ophthalmology niaj hnub no yog kev kho sai thiab tsis mob ntawm lub zeem muag. Qhov muag cornea transplantation, uas yav tas los zoo li tsis yooj yim sua, yog tam sim no ua nyob rau hauv tag nrho cov chaw tshwj xeeb. Raws li qhov tshwm sim ntawm keratoplasty, ntau tus neeg rov muaj peev xwm pom lub ntiaj teb nyob ib puag ncig lawv.
pob ntseg hloov pauv - yog dab tsi?
Txoj haujlwm no muaj lub npe tshawb fawb - keratoplasty. Nws tseem hu ua corneal transplantation. Txij li thaum lub cev ntawm lub zeem muag no tsis muaj ntshav txaus, feem ntau nws yuav siv cov hauv paus thiab kev ua haujlwm tau pom zoo. Tom qab keratoplasty, qhov muag pom tau zoo dua los yog rov qab ua tiav. Kev hloov pauv ntawm tus neeg pub dawb ntawm lub cornea ntawm lub qhov muag yog feem ntau tshwm sim. Cov khoom puas los yog lub cev tag nrho raug hloov. Qee zaum, kev hloov pauv yog ua nrog cov khoom siv dag zog. Feem ntau, qhov kev ua haujlwm no tshwm sim nyob rau hauv cov tshuaj loog. Txawm li cas los xij, qee cov kws tshaj lij pom zoo ua keratoplasty nrog tshuaj loog hauv zos. Kev ua haujlwm ntawm kev ua haujlwm tau pom zoo yuav luag txhua lub sijhawm, thiab cov teeb meem tom qab kev hloov pauv ntawm pob corneal yog qhov tsawg heev. Rau cov laj thawj no, keratoplasty yog nrhiav kev kho mob thoob ntiaj teb.
Thaum hloov pob txha pob txha ua tiav?
Kev phais pob txha pob txha tsuas yog ua raws li cov lus qhia nruj. Feem ntau, kev raug mob thiab kab mob inflammatory yog ua rau lub cev puas tsuaj. Nyob rau hauv ob qho tib si, muaj qhov tsis pom kev tsis pom kev lossis ua tiav tsis pom kev (tsawg dua). Qee zaum keratoplasty yog ua rau lub hom phiaj kho kom zoo nkauj. Cov laj thawj hauv qab no yog qhov txawv ntawm qhov kev ua haujlwm tau ua:
- Ib qhov muag. Qhov ua rau tuaj yeem yog cov kab mob dystrophic thiab raug mob ntawm lub cev ntawm qhov muag.
- YRetinopathy. Qhov no yog hais txog cov ntaub ntawv uas tsis haum rau kev kho mob. Cov no suav nrog dystrophic, bullous retinopathy.
- Kev mob rau pob txha. Tej zaum yuav tshwm sim thaum ntau lub cev txawv teb chaws nkag mus rau qhov muag.
- tshuaj kub hnyiab.
- Thinning ntawm corneal txheej. Nws yog pom nyob rau hauv ib tug kab mob xws li keratoconus.
- Ulcerative thiab erosive defects.
- Scars.
- pob ntseg clouding. Feem ntau yog qhov tshwm sim ntawm cov txheej txheem laser.
- Khaub tshuaj tsis zoo.
Contraindications rau keratoplasty
Feem ntau, qhov muag microsurgery yog thaj chaw ntawm cov tshuaj uas siv tau dav. Contraindications rau kev phais qhov muag yog tsawg. Keratoplasty yog ua rau txhua tus neeg uas muaj qhov tsis xws luag. Tsis muaj hnub nyoog txwv rau txoj haujlwm no. Txawm li cas los xij, muaj 3 yam xwm txheej uas txwv tsis pub keratoplasty. Cov no suav nrog:
- Ib qhov muag uas muaj ntshav. Lub xub ntiag ntawm cov hlab ntsha ua rau lub pob txha hloov pauv tsis tau.
- Kev sib xyaw ntawm cov kab mob cataracts thiab nce siab hauv lub cev (glaucoma).
- Cov kab mob sib kis uas muaj feem ntau ntawm kev hloov pauv tsis lees paub. Cov no suav nrog cov kab mob tiv thaiv kab mob, kab mob ntshav qab zib decompensated.
Dab tsi yog hom keratoplasty
Zoo li feem ntau cov haujlwm, keratoplasty tuaj yeem ua tau ntau txoj hauv kev. Nws nyob ntawm hom kev hloov pauv (tus pub dawb lossis lub pob zeb dag), qhov loj thiab qhov tob ntawm qhov tsis xws luag. Keratoplasty tuaj yeem yog tag nrho lossis ib nrab. Nyob rau hauv thawj rooj plaub, tag nrho cornea yog hloov. Nyob rau hauv lub thib ob - qhov chaw ntawm lub cev, qhov loj ntawm graft yog los ntawm 4 mus rau 6 mm. Tsis tas li ntawd, qee zaum subtotal retinoplasty tau ua. Nws txhais tau hais tias kev hloov ntawm lub cornea tshaj yuav luag tag nrho cheeb tsam, tshwj tsis yog ib tug me me ntug (1-2 mm) nyob ib ncig ntawm lub limbus. Nyob ntawm qhov tob ntawm qhov txhab, qhov kawg-rau-kawg thiab txheej-los-txheejhloov pauv. Nyob rau hauv thawj rooj plaub, qhov tsis xws luag occupies tag nrho cov thickness ntawm lub cev. Layered retinoplasty tuaj yeem ua rau sab nrauv thiab tom qab (cov phab ntsa sab nrauv lossis sab hauv ntawm lub pob txha raug cuam tshuam). Raws li kev pub khoom nruab nrog cev, cov khoom siv cadaveric yog siv, suav nrog cov menyuam yug tshiab. Cov khoom siv dag zog yog tsim hauv cov chaw sim tshwj xeeb.
Yuav ua li cas npaj rau keratoplasty?
Qhov muag microsurgery, zoo li lwm hom kev phais, suav nrog kev npaj ua ntej kev cuam tshuam. Ua ntej ntawm tag nrho cov, nws yog ib qhov tsim nyog los nqa tawm kev kho mob ntawm cov txheej txheem inflammatory. Qhov no siv rau txhua yam kab mob ntawm lub qhov muag thiab daim tawv muag (conjunctivitis, iridocyclitis). Tom qab kev kho mob ntawm tus kab mob, ua tiav kev kuaj mob ntawm lub cev ntawm lub zeem muag. Kev kuaj mob ophthalmological, kuaj kuaj (UAC, OAM, ntshav biochemistry) tau ua. Nws tseem yog ib qho tsim nyog kom paub seb tus neeg mob muaj cov kab mob pathologies li cas. Qhov no yog qhov tseem ceeb heev, vim qee cov kab mob yuav yog contraindications rau kev phais. Hnub ua ntej ntawm retinoplasty, nws yuav tsum tau ua raws li "kev tshaib kev nqhis".
Kev hloov lub pob ntseg
Kev hloov pob txha pob txha yog ua los ntawm cov khoom siv microsurgical tshwj xeeb. Txhawm rau ua retinoplasty, ob qho tib si kev phais thiab cov txheej txheem laser tau ua. Nyob rau hauv xyoo tas los no, txoj kev thib ob yog suav tias yog qhov zoo dua, vim nws txo qis lub sijhawm tom qab phais thiab txo qhov kev pheej hmoo ntawm cov teeb meem. Qhov muag cornea transplantation muaj cov txheej txheem tshwj xeeb. Ua ntej, tus neeg mob muab tso rau ntawm lub rooj zaum thiab tshuaj loog yog ua. Tom qab ntawd, daim tawv muag thiab lub qhov muag yog tsau (tshaj ntawm ntug ntawm lub sclera). Cov theem tom ntej yog kev tshem tawm ntawm lub cev puas tsuaj los yog ib feem ntawm nws (ua los ntawm lub laser los yog ib qho cuab yeej phais). Cov kauj ruam tom ntej yog transplantation pob txha. Cov theem kawg suav nrog kev tshuaj xyuas cov seams, tshuaj xyuas qhov teeb meem.
Postoperative lub sij hawm rau keratoplasty
Tom qab hloov lub pob ntseg, tus neeg mob yuav tsum nyob rau hauv kev saib xyuas kev kho mob tsawg kawg yog ob peb teev. Txawm tias muaj tseeb hais tias tus neeg mob raug tso cai mus tsev, nws yuav tsum tau mus xyuas los ntawm ib tug ophthalmologist. Tsis tas li ntawd, tom qab kev ua haujlwm, kev ua haujlwm tsis zoo rau lub qhov muag (qhov kev ntxhov siab tsawg kawg ntawm lub cev ntawm qhov muag) raug pom zoo. Nrog kev kho phais, cov sutures raug tshem tawm tom qab ob peb lub hlis (txog ib xyoos). Cov teeb meem tshwm sim ntawm keratoplasty yog los ntshav, o, graft rejection. Nyob rau hauv cov ntaub ntawv no, tsis xis nyob, photophobia, khaus, thiab lwm yam tshwm sim. Txhua yam tsos mob yog ib qho laj thawj rau qhov kev thov kom ceev mus rau tus kws kho qhov muag.
pob ntseg hloov pauv: kws tshuaj xyuas
Raws li kws kho mob, retinoplasty yog ib txoj hauv kev nyab xeeb thiab siv tau zoo ntawm kev kho qhov muag. Nws raug pom zoo rau txhua tus neeg mob uas tsis muaj contraindications. Cov neeg mob txaus siab rau kev ua haujlwm. Lub zeem muag tau khaws cia rau ntau xyoo tom qab hloov pauv, thiab qhov teeb meem tsis tshua muaj tshwm sim. Tam sim no, laser transplantation ntawm lub cornea ntawm lub qhov muag yog suav hais tias yog qhov tseem ceeb. Tus nqi ntawm kev ua haujlwm yog nyob ntawm qhov kev xaiv ntawm chaw kho mob. tus nqi nruab nrabyog 50-70 txhiab rubles ib qhov muag. Thaum xaiv ib qho khoom plig graft, tus nqi yog ob npaug.
